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The decision taken during the First International Congress on the
Menopause in June 1976 to repeat the exercise 2 years later turned
out to be a good one. In the last few years much work has been done
on the subject of the menopause. I t is, of course, a subject of
many facets, but of particular importance recently has been the
work done as a result of the reports appearing in 1975 and 1976
alleging an increase in the incidence of endometrial carcinoma in
women who had used oestrogens, and of other effects, some
beneficial others deleterious, reportedly seen when oestrogens were
administered. 1978 seemed the right time to re-assess the
situation, and the Second Inter national Congress on the Menopause
provided a good platform. The congress was held in Jerusalem in
June 1978. It took the form of a series of 12 workshops, each of
which, within a prescribed framework, was planned and presided over
by a moderator experi enced in that particular field. The 12
moderators were free to organize their sessions in whichever way
they wished, and to invite whoever they wished to present papers
and to join in the discussions. In addition the workshops were open
to anyone who wished to attend."
R. B. GREENBLATT The original oral contraceptives contained more
oestrogen in the form of ethinyloestradiol or mestranol and
progestagen in the form of norethynodrel or norethisterone than was
necessary f(x conception control. There has been a trend over the
years to reduce dosages of both components in order to minimize
side- eHects while ensuring eflcctiveness. However, as dosages were
lowered, there has been an increase in spotting and break- through
bleeding during the first few months of their adminis- tration. The
sequential pill appeared more physiological in that it followed
more closely physiological principles, but the need to employ large
doses ofEE or EE3ME to inhibit O\'ulation and the higher pregnancy
rate made the sequential regimen less attrac- ti\'e or useful. A
triphasic formulation has become available that takes advantage of
the synergism between ethinyloestradiol and the potent
levonorgestrel so that low doses of the oestrogen and very low
doses of the progestagen could be employed with great
effectiveness. Such a preparation is relatively free from side-
effects, partly because the basic pharmacological tenet of the
minimal dose for the desired result and the division of'the cycle
into three parts using 30 ,lIg ofEE for the first 6 days, then:)
days of 40 ,lIg, followed by 30 ,fIg for 10 da ys, for a total of21
days, thus more or less mimicking the physiological rise and fall
of 125 THE DEVELOP:'IE:-;T OF ,\ :-;E\\' TRIPH. \SIC OR.
This book contains a consensus on menopause research, a consensus
reached during the First International Congress on the Menopause in
June, 1976. The Congress brought together about 165 people, most of
whom are engaged in research in this field, in the resort town of
La Grande Motte, near Montpellier, France. It was planned so that
the main emphasis would be on the exchange of information in small
Workshop sessions. Workshop Chairmen were asked to present
summaries of their deliberations at the closing session. It is
these summaries that form the essence of this text. The Congress
also included six Free Communications sessions. They are
represented in this book by a small number of papers printed in
full (selected from some 40 contributions in all) that in the
opinion of the editors, contain data that particularly complement
the Workshop summaries. All other papers are mentioned in these Pro
ceedings by titles and by the name, affiliation and address of the
first author. Organizing this Congress was a stimulating and
heart-warming experience. It was done by the staff of the
International Health Foundation in Brussels and Geneva, under the
considerate auspices of the American Geriatric Society and the
Medical Faculty of the University of Montpellier. We are deeply
grateful to these two bodies."
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